January 05, 2018

Autism is a developmental condition — affecting one in 68 US children — that presents itself through social and communication difficulties, with children often displaying repetitive and unbending behavior. Much of autism research is focused on studies and data derived from boys, which ultimately leaves girls vulnerable to misdiagnosis and underdiagnosis of the condition because it presents differently in girls compared to boys. Often seen in girls with autism, they are mistakenly diagnosed with ADHD, OCD, or even anorexia — leading to a later diagnosis which greatly affects their treatment.

Why is autism going misdiagnosed in girls?

Many stereotypes surround children diagnosed with autism and they fall within socialization and emotional skills. You may know someone with autism who cannot make eye contact, doesn’t socialize well with others, has difficulty communicating, self-harms, unable to read others’ emotions, repetitive movements, and the list goes on.

Girls with autism are often overlooked and missed because diagnoses are being drawn from the above stereotypes, or the symptoms that are common in boys. The signs and symptoms in girls don’t fit within that narrative and are misinterpreted as something else. Physicians and health care providers may also not be versed in new autism research, so they may not even realize there is a significant way symptoms present in girls with autism.

When the current autism model is distilled down, it’s really a male autism model, which presents its own gendered issues. When comparing boys and girls in the same age range, let’s say two; the girls with autism will have better interpersonal and social skills than boys. What may be missed is instead of a girl obsessing over a certain type of play, she may be arranging her toys in a certain way — and even this is being misdiagnosed as OCD in girls! Girls are “just getting by” or have a type of social camouflage that allows this diagnosis to be evaded. Another example, is a boy may collect figurines and carry an absurd amount around with him to school and recess. He will often play alone and not want to engage with classmates. In a girl, she may collect barbies, but she’s happy to share her obsession with others and talk endlessly about why she likes each one. The difference is the boy isolates himself, while the girl engages. Adults might also see her collection as “cute” or “endearing,” and overlook the obsessive part.

Masking autism

When girls are misdiagnosed early on, this can lead to females later in life who mask or camouflage their disorder because it’s been dismissed as ADHD, OCD, depression, anorexia, or simply shyness. These women realize they’re different, and tend to create an identity they’ve created from a character or in psychology books. As a result, a diagnosis is delayed even further. Overall, what research is finding is adolescence and thereafter, autism is finally being unmasked, as a result of the people diving in and digging deep themselves.

Early intervention

Early intervention with applied behavioral analysis therapy in those with autism is the best practice, as research has shown, and significantly improves outcomes in a child’s social and emotional skills. Diagnosing autism in girls, as we’ve explored, has many opportunities for change. If you think your child has autism — even if it’s just a gut feeling — seek a second opinion and find a professional who will listen.

At Pinnacle Autism Therapy, we’re here to support you and your child in every way possible. Explore our in-home services so we can interact with your child in their natural setting, or with our clinic and specialty services. We also have in-school services and community services, multilingual ABA therapy, and workshops.